EPO and myelodysplastic syndrome: Data from 30 selected studies on MDS patients treated with ESAs at different dosing showed that HD of both rhEPO and darbepoetin induced higher HI‐E in lower‐risk MDS.21 However, in a subsequent meta‐analysis focused on rhEPO, among MDS patients treated with SD a significantly higher number of cases had marrow blasts >5% than cases treated with HD and SD patients treated had significantly higher endogenous serum EPO levels.22 Both these factors are clearly related to a poor response to rhEPO9 and possibly influenced the clinical outcome.